Articles: outcome-assessment-health-care.
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J Am Med Inform Assoc · May 2012
Multicenter StudyThe impact of electronic health records on care of heart failure patients in the emergency room.
To evaluate if electronic health records (EHR) have observable effects on care outcomes, we examined quality and efficiency measures for patients presenting to emergency departments (ED). ⋯ An EHR may have the potential to be a valuable adjunct in the care of heart failure patients.
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Randomized Controlled Trial Multicenter Study
Neurological Impairment Among Survivors of Intracerebral Hemorrhage: The FAST Trial.
Intracerebral hemorrhage (ICH) is the deadliest and most disabling form of stroke. Little is known about the causes of persistent neurological impairment among ICH survivors. ⋯ Neurological deterioration within 24 h of ICH onset is a powerful determinant of persistent neurological impairment. Careful reduction of the SBP by 1–10% in the first 24 h may lower the risk.
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Multicenter Study Comparative Study
Influence of clinical presentation on the outcome of acute B aortic dissection: evidences from IRAD.
In-hospital outcome of acute type B dissection (ABAD) is strongly related to preoperative aortic conditions. In order to clarify the influence of the clinical presentation on the outcome, we analyzed the patients of the International Registry of Acute Aortic Dissection (IRAD). All patients affected by complicated ABAD, enrolled in the IRAD from 1996-2004, were included. Complications were defined as the presence of shock, periaortic hematoma, spinal cord ischemia, preoperative mesenteric ischemia/infarction, acute renal failure, limb ischemia, recurrent pain, refractory pain or refractory hypertension (group I). All other patients were categorized as uncomplicated (group II). A comprehensive analysis was performed of all clinical variables in relation to in-hospital outcome. ⋯ ABAD is a heterogeneous disease that produces dissimilar clinical subsets, each of which can have specific clinical signs, management and in-hospital results. In IRAD ABAD uncomplicated patients, medical therapy was associated with best hospital outcome, while endovascular interventions were associated with better results than surgery when invasive treatments were required. Although selection bias may be possible, and irrespective of treatments, knowledge of significant risk factors for mortality may contribute to a better management and a more defined risk-assessment in patients affected by ABAD.
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Multicenter Study
Clinical outcome of the metal-on-metal hybrid Corin Cormet 2000 hip resurfacing system: an up to 11-year follow-up study.
This report extends the follow-up for the largest center of the first multicenter US Food and Drug Administration investigational device exemption study on metal-on-metal hip resurfacing arthroplasty up to 11 years. A single surgeon performed 373 hip resurfacing arthroplasties using the hybrid Corin Cormet 2000 system. The Kaplan-Meier survivorship at 11 years was 93% when revision for any reason was used as an end point and 91% if radiographic failures were included. ⋯ Loosening of the cemented femoral components was the most common source of failure and occurred at all follow-up intervals. A learning curve that persisted for at least 200 cases was confirmed. All femoral neck fractures occurred before 6 months postoperatively.
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J Pain Symptom Manage · Apr 2012
Multicenter StudyIs oxycodone efficacy reflected in serum concentrations? A multicenter, cross-sectional study in 456 adult cancer patients.
The relationship between oxycodone and metabolite serum concentrations and clinical effects has not previously been investigated in cancer pain patients. ⋯ This study of patients receiving oxycodone for cancer pain confirms previous observations that there is most likely no association between serum concentrations of opioid analgesics and clinical effects.